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Abstract: Background: As cardiovascular diseases have become the leading cause of death in many countries including China, nurses are increasingly required to be abreast of technological advances and the skills necessary to manage this increasing health care problem. Chinese nurses are under pressure to provide skilled electrocardiography monitoring, and be sufficiently skilled to detect myocardial ischemia and infarction, in this large patient population. This presents a challenge for the nursing profession in China, particularly for nurses working in coronary care in a country where advancement has been so rapid, yet little research has been conducted or reported in the literature. Objectives: The two main objectives were: to explore the demographic and educational factors that affect the use of ST-segment monitoring and correct electrode placement by CCU/ICU nurses in China; and to explore the factors both individual and institutional that affect monitoring and lead placement. Methods: A self-administered questionnaire was distributed to nurses in 126 randomly selected tertiary hospitals, which were stratified into three homogeneous regions across China. The instrument examined demographics, information about hospitals, electrocardiogram devices, current practice patterns and perceptions toward monitoring and lead placement. Data from 734 nurses and 59 nurse managers from 59 hospitals were analyzed using t-tests, ANOVA, Chi-square test and logistic regression. Results: Electrocardiogram monitoring was used to detect myocardial ischemia by 43.7% of respondents, and 35.1% selected leads according to electrocardiogram or angiography findings. Most (70%) agreed that monitoring for acute coronary syndrome was important, while 39.2% did so, and 15.7% were able to identify correct placement. Logistic regression revealed a significant relationship between the uses of ST-segment monitoring and number of hospital beds, continuing education and a belief in its use and ease of use. Correct electrode placement was significantly correlated with respondents from university hospitals, hospitals with more acute coronary syndrome admissions and more independent thinking nurses. Conclusions: Despite best practice evidence, less than half of the sample used electrocardiogram monitoring to detect myocardial ischemia and the majority could not identify correct electrode placement, while ST-segment monitoring was not used routinely. This paper highlights the need for improvements in education both in universities and hospitals and discussion addresses conventions in units, which inhibit development of nurses’ skills. [Copyright &y& Elsevier]

• Adopted Chinese youth scored more favorably on BASC-3 than non-adopted Chinese youth. • Adopted Chinese youth scored more favorably on BASC-3 than non-adopted US youth. • High adoptive family SES benefited adopted youth adjustment. • Testing measurement invariance is important for cross-cultural comparison. In this paper, we examined if high SES families had an effect on youth's adjustment by comparing 226 internationally adopted female Chinese youth who experienced pre-adoption institutionalization with 1059 non-adopted Chinese peers living in China, as well as 209 non-adopted American peers. On average, the adopted youth's families had a higher SES status than the two comparison groups. Survey data on behavioral problems and prosocial adjustment were collected with the third edition of the Behavioral Assessment for Children (BASC-3). We found the adopted Chinese youth outperformed their Chinese counterparts in all comparisons and their US counterparts in most comparisons. These results offer some evidence that a high family SES may compensate for the adoption-related risks such as earlier institutionalization. Possible mechanisms underlying the benefit of high SES were discussed. [ABSTRACT FROM AUTHOR]